OSCE LEARNING POINTS

OSCE LEARNING POINTS 
 
1. What is PUO?
 Increase in body temperature more than 38.3 °C (101.0 °F) for at least 21 days or three weeks without any established aetiology (cause) after being a thorough clinical evaluation
2.Types of PUO?
CLASSICAL PUO: Increase in body temperature for more than 3 weeks and duration of hospital stay is 3 days or 3 outpatient visits without detecting a cause or 1 week of thorough investigations 

NOSOCOMIAL PUO: Temperature of more than 38.3 C developing on several occasions in a  Hospitalized patient in whom infection was not manifested or incuabting on admission  with 3 days of investigations including atleast 2 days incubation  of cultures

NEUTROPENIC PUO: Temperature of more than 38.3 C developing on several occasions in a patient whose neutrophil count is less than 500/ microlit or expected to fall in 1-2 days .

HIV ASSOCIATED PUO:Temperature of more than 38.3 C on several occasions for a period of more than 4 weeks for outpatient or  more than 3 days for inpatients  with HIV with 3 days of investigations including atleast 2 days incubation  of cultures.

3. Patterns of fever ?
Continuous fever : Temperature remains  elevated above normal not touching the baseline and fluctuation so not exceed 0.6C
Remittent Fever: Temperature fluctuation exceeds more than 0.6 C
Intermittent Fever : Elevated temperature touches the baseline in between 
Relapsing fever:Febrile episodes are seperated by normal temperature for more than 1day 



LEARNING POINTS 
  • Learnt how much a fever chart is important 
  • I have learned about patterns of fever 
  • Learnt how much daily routine is important in a patient case
  • Learnt the importance of patient’s whole history
  • I learned about importance of timely investigations in thi case




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